Prevalence of malnutrition/malnutrition risk and nutrition-related risk factors among patients with Parkinson's disease: systematic review and meta-analysis

Dietary quality and the gut microbiome in early-stage Parkinson's disease patients

BACKGROUND

The prevalence of Parkinson's disease (PD) has increased steadily with the increase of the elderly population. PD may influence dietary intake and quality, and the gut microbiome composition. The present study examined differences in dietary intake and quality between PD patients and controls according to sex. In addition, we assessed the gut microbiome composition.

METHODS

This cross-sectional study was conducted at A Medical Center, Seoul, South Korea. PD severity, swallowing function, olfactory function, and constipation status were examined by a skilled nurse. Dietary data were collected through a semi-quantitative food frequency questionnaire. Stool samples were subjected to microbiome analysis. To examine dietary quality, the Dietary Quality Index-International (DQI-I), Healthy Eating Index (HEI), Index of Nutritional Quality (INQ), Dietary Diversity Score (DDS), and Mediterranean Diet Score (MDS) were used. An independent t-test was used to determine differences between patients and controls. A chi-square test was used to examine frequency differences.

RESULTS

Dietary intake did not differ between the PD patient and control groups. Regarding dietary quality, the patients consumed more saturated fat compared to controls. Overall, the dietary differences between the groups were minor. The composition of the gut microbiome differed between PD patients and controls. Lactobacillus and Bifidobacterium genus were most abundant in PD patients. Prevotella VZCB and other Faecalibacterium were most abundant in controls.

CONCLUSIONS

Our results indicated that PD patients may experience gut microbiome change even in the early stage, while nutritional needs can be met when a balanced diet including various food groups are consumed.

A case report of pancreatic exocrine insufficiency in a patient with Parkinson's disease: A coincidence or is there more to it than meets the eye?

Pancreatic exocrine insufficiency (PEI) is an under-diagnosed condition. Untreated PEI can result in developing gastrointestinal symptoms and long-term complications including weight loss, nutrient deficiencies, sarcopenia and osteoporosis. Current best practice recommends testing for PEI in certain disorders including chronic pancreatitis, cystic fibrosis, pancreatic cancer and post-pancreatic surgery. However, there is increasing evidence that PEI is associated with a number of conditions in addition to the aforementioned diseases. These 'at-risk' conditions are a heterogeneous group of diseases, for example, diabetes mellitus, people living with human immunodeficiency virus, high alcohol intake, and coeliac disease. The pathophysiology of some of 'at-risk' conditions is becoming increasingly recognised; therefore, the list of associated conditions are in evolving process. We present a case of a 60-year-old male with Parkinson's disease and persistent abdominal pain who was found to have low faecal elastase levels indicative of severe PEI. His past medical history included none of the known risk factors for PEI. After examining the literature, we report a similar pathophysiological process underlying the development of pancreatitis and Parkinson's disease which is dysfunction of the Unfolded Protein Response. We suggest further research to assess the prevalence of PEI in the population of patients with Parkinson's disease.

Dietary interventions in Parkinson’s disease: An update

Parkinson’s disease (PD) is a progressive neurodegenerative disorder mostly affecting the elderly population. Nutritional status, dietary habits, and physical activity are closely associated with PD clinical symptoms. Based on scientific evidence, lifestyle adjustments are being considered as therapy approaches in various chronic diseases. Dietary modifications are an additional treatment strategy for managing motor and non-motor symptoms in PD. This review focuses on the latest nutritional interventions with protein restriction, Mediterranean and ketogenic dietary modification, probiotic utilisation, and their impact on PD.

Effects of Pramipexole Combined with Nerve Growth Factor on Cognitive Impairment and Urinary AD7c-NTP Expression in Patients with Parkinson’s Disease

Objective

To explore the effects of pramipexole combined with nerve growth factor (NGF) on cognitive impairment and urinary Alzheimer-associated neural thread protein (AD7c-NTP) expression in patients with Parkinson's disease (PD).

Methods

Fifty patients with PD treated in our hospital from February 2020 to April 2021 were enrolled. The patients were arbitrarily assigned into control group and study group. The former was treated with pramipexole, and the latter was treated with pramipexole combined with NGF. The efficacy, cognitive function, serum inflammatory factors, cortisol levels, serum macrophage migration inhibitory factor (MIF), brain-derived neurotrophic factor (BDNF), urine AD7c-NTP levels, and the incidence of adverse reactions were compared.

Results

First of all, the effective rate in the study group was higher compared to the control group (P < 0.05). After treatment, the cognitive function was enhanced, and the scores of Montreal cognitive assessment (MoCA) in the study group were higher compared to the control group (P < 0.05). The levels of serum IL-6, CRP, and TNF-α decreased after treatment, and the levels of serum IL-6, CRP, and TNF-α in the study group were remarkably lower compared to the control group (P < 0.05). In addition, the levels of serum DA, NE, and 5-HT increased after treatment, and the levels of serum DA, NE, and 5-HT in the study group were remarkably higher compared to the control group (P < 0.05). Then, the levels of serum MIF and urine AD7c-NTP decreased and BDNF increased after treatment, and the level of BDNF in the study group was higher compared to the control group, while the levels of serum MIF and urine AD7c-NTP in the study group were lower compared to the control group (P < 0.05). Finally, the adverse reactions were compared. The incidence of adverse reactions in the study group was lower compared to the control group, and the difference exhibited not statistically significant (16.00% vs. 24.00%, P > 0.05).

Conclusion

Pramipexole combined with NGF therapy not only can effectively strengthen the cognitive impairment of patients with PD and promote clinical efficacy and high safety but also can inhibit inflammatory state, regulate brain neurotransmitters, and reduce urinary AD7c-NTP levels.